Flashcards in Cerebral Palsy Deck (18):
What is CP?
static lesion in the immature brain that leaves children with a permanent motor impairment
How does a lesion occur to cause CP?
developmental defect, MCA occlusion causing an infarction, trauma during or after delivery
What is the etiology breakdown for CP?
Prenatal (genetic syndroms, teratogenic (alcohol), viral infection, twin pregnancies= 40%
Perinatal (pre-exclampsia, birth asphyxia, cerebral artery infarction)= 55%
Postnatal (hypoxic ischemic injury, anoxia, cerebral traumatic injury, meningitis)= 5%
What are associated disorders with CP?
persistence of primitive reflexes
what are the topographical classifications of CP
hemiplegic (all 1 side)
diplegic (both UE and LE)
triplegic (both feet and 1 UE)
What are the two physiologic classifications of CP?
pyramidal or spastic type
What is spasticity?
disorder of muscle tone characterized by an initial increased resistance to stretch (75% of CP cases)
Extrapyramidal CP is damage to what brain structures and causes what
damage to the basal ganglia or cerebellum which results in movement disorders
Athetoid CP effects what part of the brain
damage to motor area of cerebral cortex
flaccid muscle tone, "floppy"
child will over or under-reach for objects (dysmetria)
gait is ataxic and wide-based
involvement of one side of body
arm more affected than leg
definite hand preference in children less than 12 months
sitting and crawling at normal age, but walking is delayed
lower limbs more involved than upper limbs
shuffling gait, w/flexion/adduction of hips and flexion of knees
growth of lower limbs suffers, but upper limbs grow normally.
can use a WALKER
severe mental retardation
visual and hearing deficits
hypertonicity leads to arching of the back
scissoring of legs
arms internally rotated
purposeless movements which are uncontrollable. These movements may be slow or fast, writhing, jerky, swiping, tremor, or rotary patterns
fluctuates with emotional state. fatigue decreases athetosis
Patterns that show increase in tone
shoulder internal rotation
Medical Management of CP
Baclofen: muscle relaxer and antispastic agent
Botox: reduces spasticity by blocking neurmuscular transmissions by binding to receptors sites and inhibits release of acetycholine.
CITM: forced use of involved extremity by using a splint/cast and doing repetitive adaptive tasks with involved extremity
What is the widely used intervention for CP?
Neurodevelopmental Treatment (NDT): key points are the places of physical contact b/w therapist's parts of the body/equipment and client's body